跨区供血小腿前外侧皮瓣修复足部皮肤软组织缺损  

Repair of foot skin and soft tissue defect by anterolateral crural flap with extra-territorial blood supply

作　　者：幸超峰[1] 周明武[1] 杨瑞甫[1] 宋力[1] 李士民[1] 王飞云[1] 王瑞金[1] 熊颖杰[1] 

机构地区：[1]解放军第153中心医院全军创伤骨科中心手外科,郑州450042

出　　处：《临床外科杂志》2013年第5期381-383,共3页Journal of Clinical Surgery

摘　　要：目的 探讨应用跨区供血小腿前外侧皮瓣修复足部皮肤软组织缺损的方法及疗效.方法 采用跨区供血小腿前外侧皮瓣逆行转移修复足部皮肤软组织缺损12例,皮瓣切取面积32cm×17cm～15cm×7cm.以腓动脉终末穿支为蒂8例,以腓动脉终末穿支降支为蒂4例.结果 皮瓣完全成活11例,1例术后发生静脉回流障碍,皮瓣远端部分坏死（面积约1.0cm×1.5cm）,经换药伤口愈合.随访时间6个月～3年,皮瓣外形满意,供区植皮无溃疡或磨损,行走步态接近正常.结论 采用跨区供血小腿前外侧皮瓣修复足部皮肤软组织缺损,手术操作相对简单,不损伤主干血管,皮瓣供血可靠,是修复足部大面积皮肤软组织缺损的理想皮瓣.Objective To explore the methods and clinical efficacy of anterolateral calf flap with extra-territorial blood supply in repairing foot skin and soft tissue defects. Methods From Jun. 2007 to Jun. 2011,12 cases received repair of foot skin and soft tissue defects by anterolateral calf flap with extraterritorial blood supply and the area of flaps ranged from 32 cm × 17 cm to 15 cm × 7 cm. The flaps were pedicled with the distal perforating branch of the peroneal artery in 8 cases and others were pedicled with descending branch of the distal perforating branch of the peroneal artery in 4 cases. Results The flaps survived in 11 cases and venous reflux disorder occurred in 1 case which caused the necrosis of the distal portion of the flap（ area 1.0 cm × 1.5 cm）and then healed up gradually through dressing change. Followed up for 6 months to 3 years, the patients were satisfied with the shape of the flap. No ulceration or abrasion occurred in the donor area and the walking gait was nearly normal. Conclusion Repairing foot skin and soft tissue defects by anterolateral crural flap with extra-territorial blood supply has advantages of less trau- ma and simple operation. The blood supply of the flaps was reliable without sacrificing the main vessel. It is a safe and valid operative method to repair skin and soft tissue defect at foot.

关 键 词：外科皮瓣 腓动脉穿支 跨区供血 移植 腓浅动脉 

分 类 号：R622.9[医药卫生—整形外科]